Friendships after brain injury: why they change and how to keep them

Friends group with arms around each other.

Friendships often change after a brain injury. Friends are an important part of recovery and long‑term stability, but brain injury can alter almost every layer of social life over time. Some friendships may fade away or break down, while others grow stronger as people learn about brain injury together and adjust to the new realities of everyday life.

Why do friendships change after a brain injury?

When someone experiences a brain injury, it can be like throwing a stone into a lake: the impact is at the centre, but the ripples spread out to everyone who cares about them. Friendships feel these ripples in different ways, including physical, emotional, and social changes.

Friendships often change because the injury affects both the person’s abilities and how friends need to respond. Invisible changes like memory problems, fatigue, or altered communication can be misread as disinterest, moodiness or rudeness. This can strain the relationship and make it harder for friends to understand what is really going on.

Many people also notice emotional and personality shifts after a brain injury. Irritability, anxiety, low motivation or reduced empathy can make social time more challenging. This can increase conflict, misunderstandings or emotional distance.

Friends may also be grieving the “before brain injury” version of you, which can bring sadness, frustration and confusion into the relationship.

How much a friendship changes depends on several things:

• How well everyone understands, or is willing to understand, brain injury.
• Whether there is practical support, counselling and respite available.
• If friends can find new ways to connect that fit your current strengths, limits and energy.

Practical ways to keep friendships after brain injury.

Friendships can survive and adapt after brain injury, but they often need more explanation and structure than before. You may find it helpful to:

• Share simple information about your brain injury and how it is affecting you. For example, you might explain that you get tired easily, find it hard to hold on to information, or notice your mood changing quickly. You can use fact sheets or Synapse resources to help you talk through these changes.
• Explain to friends what has changed in everyday life. Let them know if you need more time to answer questions, sometimes forget plans, or struggle in busy or noisy places.
• Be specific about what helps and what does not help. You might suggest quieter venues, shorter catch‑ups, earlier times of day, or one‑on‑one catch‑ups instead of large group events.
• Keep in touch in small, regular ways. Text messages, short phone calls or WhatsApp and Messenger chats can help you stay connected, instead of waiting for a long meet‑up that may be hard to organise or manage.
• Ask to build new routines together. This could be going for a walk, catching up over a coffee instead of a long dinner, or visiting each other at home, where you feel more comfortable.

These practical steps help friends see that your friendship is still important and give them clear ways to support you in ways that work with your brain injury.

Finding hope in changing friendships.

Friendships after brain injury rarely go back to exactly how they were before, but they can still be close, meaningful and worth holding onto. By talking openly, you give your friendships a real chance to adapt rather than quietly fade away.